Provider Demographics
NPI:1003005497
Name:NINIGRET ORTHOPEDICS INC
Entity Type:Organization
Organization Name:NINIGRET ORTHOPEDICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-596-9039
Mailing Address - Street 1:81 BEACH ST
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-2769
Mailing Address - Country:US
Mailing Address - Phone:401-596-9039
Mailing Address - Fax:
Practice Address - Street 1:81 BEACH ST
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2769
Practice Address - Country:US
Practice Address - Phone:401-596-9039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI8611207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI21202-7OtherBLUE CROSS
9790006084OtherMEDICARE PA PTAN
RI209082059Medicare PIN
RI21202-7OtherBLUE CROSS
6160710001Medicare NSC